Q: Lately my stomach has been growling a lot, sometimes before and sometimes after I eat. Is there something wrong with me, and should I get it checked? - Chris H., Poughkeepsie, New York
A: If you're not having any pain, chances are you're experiencing simple borborygmi. The word sounds like a growl and comes from the Greek, borborugmos, which means "to have a rumbling in the bowels." It can happen when you're hungry, as part of a normal digestive process, or from indigestion.
When you're hungry, your stomach and intestines release acids and enzymes to prepare for the arrival of food. That can make a sound, and it's easier to hear when your stomach is empty. If it happens when or just after you eat, your borborygmi is probably the sound of food and liquid passing from the stomach to the small intestine. If it happens well after you've eaten, it's probably indigestion. All pretty normal.
However, if it becomes a persistent problem and you're feeling pain and have nausea, flatulence (gassiness) and/or diarrhea along with the growls, it's time to see a gastroenterologist. The doc can determine if there is an underlying medical cause. Possible triggers include food allergies or intolerances and irritable bowel syndrome (IBS).
You can also see if an elimination diet helps quiet your belly. That means you cut out certain foods, and then after a week or so you see if the symptoms go away. Then you reintroduce food and see if they reoccur.
You might start with eliminating dairy. Around 65% of people have some form of lactose intolerance, which is caused by a lack of the digestive enzyme lactase. If you think dairy is the culprit, you can opt for lactose-free "milks" made from soy or almonds and other nuts. (It's a trend: U.S. whole milk consumption has plummeted by 40% over the past four decades.) So don't worry too much, and see a gastroenterologist if you have persistent discomfort.
Q: I have three daughters. My oldest (23) doesn't like going to the gynecologist. My middle one (18) puts up with it, and my youngest (14) is about to have her first visit. How can I make sure my youngest is comfortable talking to her doc? - Susie C., Boca Raton, Florida
A: Good gynecological care starting at age 13 to 15 is important to protect young women from a wide range of potential health problems. Helping your daughter become comfortable with the appointment and exam will take support from both you and the doctor.
To find a doctor that your daughter can be comfortable with, ask friends and your primary care doc for references. Also, we assume you have a gyno you see regularly (if you don't, you need to get one too!), so that's a place to start.
You're looking for a doctor who understands how to interact with young teens just getting into the habit of having pelvic exams and PAP smears. Don't hesitate to interview the doc before you set up an appointment.
He or she should be interested in talking to young patients, and asking questions, before doing any examination. The first appointment should be a chance for your daughter to get to know the doc; the physical exam can come in a follow-up.
Tell your daughter she can come to her first appointment with questions written down. Do not ask to see them! You want her to be able to ask questions of the doc that she might not be comfortable asking you. Also, let her know the doctor may ask questions that seem personal or embarrassing. Assure her that the conversation is just between her and the doctor. Lastly, tell your daughter that if she is uncomfortable, she can say, "I want to go home and think about things, if that's OK." A good doc will say, "I completely understand and we're not going to do anything until you're ready."
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